Almost everyone agrees that we need some kind of health care reform. The cost of care is accelerating at a pace that, if unchecked, will eventually crush households and communities. However, untangling the Gordian knot that our health care system has become is a very tough challenge. The challenge is made even more difficult by differences in the cost of care between regions. Click on the image above to go to an interactive chart showing Medicare payouts per beneficiary during 2006. The differences will astound you.

I learned a very personal lesson about regional differences in the cost of care in 2005. In January of 2005 I woke up early one morning with a nagging pain in my lower right abdomen. I tried to ignore it, but the pain steadily increased. Alarmed, my wife took me to the hospital and before I knew it, I was having surgery to remove a troubling appendix. It was a routine surgery without any complications. In fact, by the afternoon of the following day I was back at home.

In August of 2005, I was involved in a bicycle accident while on vacation in Utah. A leisurely morning ride turned into a 5-day hospital stay complete with a punctured lung, a broken clavicle and several broken ribs. The punctured lung required that a chest tube be inserted to drain the fluid--a surgical procedure performed while I was under general anesthesia.

In many ways, the experiences were similar. The quality of care in both places was outstanding. Both experiences entailed a trip to the emergency room, various x-rays and scans, surgery with general anesthesia and a stay in the hospital. Yet, amazingly, the total cost of the 5 day ordeal in Utah was about 1/4 of the shorter and relatively easier care I received in California!

As you can imagine, I was shocked when I compared the two bills. I'm not sure what accounts for the total difference, but these kinds of extreme differences raise serious questions about the future of health care reform.